Individual
JASMINE IVONNE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 GREENWOOD ST STE A, WORCESTER, MA 01607-1767
(508) 363-0200
(508) 363-1213
Mailing address
36 MARSH AVE, WORCESTER, MA 01605-2215
(508) 410-2779
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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